US8435259B2 - Surgical tool arrangement and surgical cutting accessory for use therewith with the tool arrangement including a toothed cutting edge and a generally straight cutting edge - Google Patents

Abstract

A surgical tool arrangement for performing endoscopic surgical procedures which includes a powered handpiece and a cutting accessory which detachably connects to the handpiece and incorporates multiple blade configurations or styles into one accessory. The accessory includes a cutting element which rotates within an outer housing element, wherein each element has a cutting window at its distal end, and one of the cutting windows has two sides which have differently configured cutting geometries. One of the cutting windows has a first side with a cutting edge that is toothed and a second side with a cutting edge that is generally straight.

Description

CROSS REFERENCE TO RELATED APPLICATION

This application claims the benefit of U.S. Provisional Application Ser. No. 61/216,557, filed May 19, 2009, which is incorporated herein by reference in its entirety.

FIELD OF THE INVENTION

This invention generally relates to a surgical tool arrangement useful for performing endoscopic surgical procedures which includes a powered handpiece and, more particularly, to a cutting accessory which detachably connects to the handpiece and incorporates multiple blade configurations which allow the user to perform multiple cutting styles with one accessory.

BACKGROUND OF THE INVENTION

Endoscopic surgical procedures are routinely performed in order to accomplish various surgical tasks. In such a surgical procedure, small incisions or portals are made in the patient. An endoscope, which is a device that allows medical personnel to view the surgical site, is inserted in one of the portals. Surgical instruments used to perform other tasks are inserted into other portals. The surgeon views the surgical site through the endoscope to determine how to manipulate the surgical instruments in order to accomplish the desired procedure. An advantage of performing endoscopic surgery is that, since the portions of the body that are cut open are minimized, the portions of the body that need to heal after the surgery are likewise reduced. Moreover, during an endoscopic surgical procedure, only relatively small portions of the patient's internal organs and tissue are exposed to the open environment. This minimal opening of the patient's body lessens the extent to which a patient's organs and tissue are open to infection.

The ability to perform endoscopic surgery is enhanced by the development of powered surgical tools especially designed to perform such procedures. Once such tool is sold by the Assignee hereof under the trademark FORMULA®. This tool is in the form of a cylindrical handpiece designed to be held in the hand of the surgeon. The handpiece has a front or distal end provided with a coupling assembly for releasably holding a cutting accessory, and a motor disposed within a handpiece housing which drives the accessory. One such cutting accessory, often termed a “shaver”, includes a hub which defines the proximal end of the accessory and is appropriately configured to cooperate with the coupling assembly of the handpiece to lock the accessory thereto, an elongated and tubular housing element having a proximal end fixed to the hub, and an elongated cutting element including a drive shaft disposed within the housing element. When the accessory is attached to the handpiece, the handpiece motor couples to the drive shaft of the accessory and moves same relative to the outer housing element. The handpiece motor is selectively actuable to drive the accessory drive shaft so as to cause a desired cutting action at the distal end of the accessory. The handpiece is associated with a control unit which controls the functioning thereof, and is actuated by the user via appropriate buttons provided on the handpiece itself, or alternatively directly at the control unit.

In an endoscopic surgical procedure, irrigating fluid is introduced into the surgical site. This fluid serves as a transport media for removing tissue and debris from the surgical site. In order to remove the irrigating fluid and the material contained therein, the above handpiece and the various accessories which are usable therewith together define a suction conduit. A suction pump is connected to the handpiece to provide the suction force needed for drawing the fluid and material away from the surgical site. In order to control the suction flow through the accessory and the handpiece, the handpiece is provided with a manually operated valve which is manipulated by the surgeon to control suction of material away from the surgical site.

Mechanical cutting accessories, such as the shaver discussed above, are commonly used in arthroscopic procedures, and allow for the resection of hard and soft bodily tissues, for example, those found within the knee, shoulder and other joints. In such a cutting accessory, the outer housing element defines a window or opening at the distal end, which window is defined by an edge of the wall of the outer housing element. The cutting element drive shaft at the distal end thereof also defines a window defined by an edge of the wall of the drive shaft, and when the drive shaft is disposed within the housing element, the drive shaft window is positioned adjacent the window of the housing element. As the drive shaft is moved relative to the housing element by the handpiece motor, the cutting edge of the drive shaft window and the opposed and facing cutting edge of the housing element window cause a cutting action which effectively severs tissue located within the housing element window and between the opposed cutting edges of the housing element and drive shaft. The configurations of these opposed edges allow for removal of particular tissue types, and a variety of different blade geometries are available to specifically address the type of cutting the accessory is to carry out. For example, providing the windows of both of the housing element and drive shaft with straight cutting edges is useful for making fine or detailed cuts and removing areas of hard tissue, such as bone. Alternatively, providing the distal ends of both the housing element and drive shaft with toothed or serrated cutting edges achieves a more aggressive cut and is useful for removal of soft fibrous tissue. Thus, a surgeon may often need to switch cutting accessories during a procedure in order to carry out the appropriate type or style of cut.

While the above-described surgical accessories have proven useful, when a change in cutting is desired, these accessories require the user to remove the accessory currently in use from the patient, to remove the accessory from the handpiece, install a different accessory onto the handpiece, and then reinsert the new accessory into the surgical site. Further, the known arrangements require the purchase of a multitude of accessories, which results in higher costs and a larger number of surgical accessories which must be present in the operating room in order to carry out the desired surgical procedure.

In order to obviate or at least minimize the above disadvantages of known arrangements, the surgical accessory according to the invention combines two types of cutting styles into one accessory. Specifically, in one embodiment, the two opposite sides of the cutting window of each of the outer housing element and the cutting element drive shaft have differently-configured cutting geometries, such that each window combines two different blade styles into one window. Further, the cutting geometries of the housing element window and the cutting element drive shaft window are reversed from one another, such that the accessory will perform one cutting style in one direction of rotation of the drive shaft, for example, a “straight-on-straight” cutting style wherein the opposed cutting edges of the drive shaft window and the housing element window are both straight, and such that the accessory will perform a different cutting style in an opposite direction of rotation of the drive shaft, for example, a “tooth-on-tooth” cutting style wherein the opposed cutting edges of the drive shaft window and the housing element window are both serrated or toothed. Providing this type of blade geometry on an accessory allows the surgeon to perform two different types of cutting without having to remove the accessory from the patient and then from the handpiece, thus saving time during a procedure and reducing equipment costs.

A further embodiment of the invention also combines two types of cutting styles into one accessory. In this embodiment, a surgical accessory is provided which includes a tubular housing element in which an inner cutting element is disposed for rotation relative thereto. Further, an outer sheath is provided over the housing and cutting elements, which sheath defines an opening or window at its distal end. The housing element in this embodiment is thus an intermediate component located radially between the sheath and the cutting element. The housing element defines therein a pair of windows located on opposite sides of the distal end thereof, wherein one of these windows is configured with a first cutting style, and the opposite window is configured with a second cutting style different from the first cutting style. The cutting element located within the housing element also defines a cutting window at its distal end, which window is configured with a cutting style which in one embodiment matches the cutting style of one of the housing element windows.

The outermost sheath is movable relative to the housing and cutting elements, and can be moved by the user into a first position wherein the sheath opening is circumferentially aligned with one of the cutting windows of the housing element, or a second position wherein the sheath opening is aligned with the other or opposite cutting window of the housing element. While the first embodiment discussed above allows the surgeon to select the type of cutting style by changing the direction of rotation of the cutting element drive shaft relative to the housing element, this embodiment allows the user to rotate the outer sheath relative to the housing and cutting elements to select the type of cutting style desired.

Alternatively, the two cutting edges of the cutting window of one or both of the cutting element or housing element may be provided with different geometries as in the first embodiment, and the cutting element can be actuated in different rotational directions to provide additional or alternative cutting-style options.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of the surgical tool arrangement according to the invention, including a handpiece with a surgical accessory attached thereto;

FIG. 2 is an enlarged, fragmentary longitudinal cross-sectional view of the handpiece ofFIG. 1 with a surgical accessory attached thereto;

FIG. 3 is an enlarged top and fragmentary view of the surgical accessory;

FIG. 4 is an enlarged longitudinal cross-sectional view of the surgical accessory ofFIG. 3, as seen generally along line4-4 inFIG. 3;

FIG. 5 is an enlarged, fragmentary and exploded view of distal ends of the housing element and drive shaft of the surgical accessory ofFIG. 3;

FIG. 6 is an enlarged and fragmentary view of the distal end of the surgical accessory ofFIG. 3;

FIG. 7 is an enlarged top and fragmentary view of a further embodiment of a surgical accessory;

FIG. 8 is an exploded view of the sheath, housing element and drive shaft of the surgical accessory ofFIG. 7;

FIG. 9 is an enlarged, fragmentary and partial cross-sectional view of the distal end of the surgical accessory ofFIG. 7;

FIG. 10 is an enlarged and fragmentary view of the distal end of the surgical accessory ofFIG. 7, with the sheath rotated approximately 180 degrees from the position thereof inFIG. 9; and

FIG. 11 is an enlarged and fragmentary view of the distal end of a further embodiment of a cutting element which may be utilized with the accessory ofFIG. 7.

Certain terminology will be used in the following description for convenience in reference only, and will not be limiting. For example, the words “upwardly”, “downwardly”, “rightwardly” and “leftwardly” will refer to directions in the drawings to which reference is made. The words “inwardly” and “outwardly” will refer to directions toward and away from, respectively, the geometric center of the arrangement and designated parts thereof. The words “forwardly” and “distally” will refer to the direction toward the end of the arrangement which is closest to the patient, and the words “rearwardly” and “proximally” will refer to the direction toward the end of the arrangement which is furthest from the patient. Said terminology will include the words specifically mentioned, derivatives thereof, and words of similar import.

DETAILED DESCRIPTION

Referring toFIGS. 1 and 2, asurgical tool arrangement10 according to the invention is illustrated. Thearrangement10 includes ahandpiece11, which at its distal end mounts thereon asurgical accessory12.

Handpiece11 is a commercially available surgical handpiece manufactured by the assignee hereof, under Model Nos. 375-704-500 and 375-701-500, and is accordingly only briefly described herein.Handpiece11 includes an elongateouter housing13 defining anelongate bore14 therein. A motor15 (shown diagrammatically only inFIG. 1) is disposed within housing bore14.Motor15 includes an output or driveshaft16, which driveshaft16 mounts adrive pin17 at the distal end thereof. Apower cable18 is coupled to the proximal end ofhandpiece11 for supplying power tomotor15.

Handpiece housing13 defines therein an elongate suction bore (not shown) extending generally parallel to and sidewardly of housing bore14. This suction bore communicates with a diagonally extendingsuction passage20 defined inhousing13, whichpassage20 provides communication between the distal end of housing bore14 and the suction bore. Suction is drawn through thehandpiece11 by a suction pump (not shown), which is connected to thehandpiece11 via asuction tube21. Suction flow through thehandpiece11 is regulated by anadjustable valve22 having a valve stem (not shown) which is movably mounted in a valve bore23 defined inhousing13. Thevalve22 is adjusted by the user via a movable handle orarm24 connected to the valve stem. The above handpiece suction arrangement is described in detail in U.S. Patent Application Publication No. 2003/0135151A1 published on Jul. 17, 2003, which is owned by the same assignee hereof and is hereby incorporated by reference herein.

Theaccessory12 is removably attached to the distal end of thehandpiece11 by acoupling assembly25 provided on thehandpiece11. Couplingassembly25 includes a generally ring-shapedcollet26 secured to the distal end of thehandpiece housing13. A lockingring27 is movably disposed incollet26 and is biased to hold theaccessory12 within the housing bore14 ofhandpiece11. Arelease button28 is provided on lockingring27, and is used to release the lockingring27 and allow removal of the accessory12 fromhandpiece11. Further, acoil30 is provided incollet26, which is used to facilitate inductive signal transfer to/from a radio-frequency identification device (RFID) disposed in the accessory12 as discussed below.

Referring toFIGS. 2-4, theaccessory12 will now be described.Accessory12 includes an outer cannula ortubular housing element32 and atubular cutting element33 disposed withinhousing element32.Housing element32 includes ahub34 which defines the proximal end thereof.Hub34 is defined by a generallytubular base body35, which defines therein a pair of generally rectangular and diametrically-opposedopenings36 adjacent the proximal end thereof.Base body35 also has formed thereon a pair of outwardly-projecting, diametrically opposed and generally ramp-shapedears37 disposed distally ofopenings36.Ears37 cooperate withcoupling assembly25 ofhandpiece11 to secureaccessory12 therein.Hub34 has a distal end defined by ahead39 or nose of a reduced diameter as compared tobase body35. In the illustrated embodiment, athread40 extends about the circumference ofhead39, whichthread40 may be used to attach an operating cannula (not shown) overhousing element32. Further,hub34 defines therein abore41 which extends completely through thehub34, and with whichopenings36 ofbase body35 communicate.

Anannular seal45 is disposed within the proximal end ofbore41 ofhub34.Seal45 is constructed of a resilient elastomeric material, and is defined by amain section46 and axially-spaced proximal anddistal sections47 and48 disposed at respective opposite ends of themain section46.Proximal section47 defines thereon a pair ofannular ribs55 and56, which are disposed in sealing engagement with an inner annular surface ofcollet26 ofhandpiece11 whenaccessory12 is coupled thereto, as shown inFIG. 2.Distal section48 defines thereon a pair of outwardly projecting and diametrically-opposed lock tabs57 which engage within therespective openings36 ofhub34 to secure theseal45 tohub34 and fix the axial position ofseal45 relative thereto.Distal section48 additionally defines thereon a pair of inwardly projecting and diametrically-opposedstop tabs58, which are generally radially aligned with therespective lock tabs57. As shown inFIGS. 2 and 4, anRFID device59 encapsulated within a ring structure is located within hub bore41 distally from, and in axially-adjacent relationship with, thedistal section48 ofseal45.

The above-described coupling arrangement ofhandpiece11 and the arrangement of the encapsulatedRFID device59 andcoil30 are disclosed in U.S. Patent Publication No. 2004/0220602A1 published on Nov. 4, 2004, which publication is owned by the same assignee hereof and is hereby incorporated by reference herein.

Housing element32 additionally includes anelongate housing tube64 which projects distally fromhub34. More specifically,housing tube64 has a proximal end which is fixedly mounted within the distal portion ofbore41 ofhub34.Housing tube64 defines an elongate bore orconduit65 therein, in which the cuttingelement33 is disposed as discussed below. As best shown inFIGS. 6 and 7,housing tube64 has adistal end66 which is cut so as to define awindow67, whichwindow67 in the illustrated embodiment opens generally sidewardly of thetube64, such that thedistal end66 is generally closed in the axial direction. The cutting of thehousing tube64 results in a ring-shaped edge ofhousing tube64 which defines cuttingwindow67, which edge has circumferentially-spaced and opposed and generally longitudinally-extendingsides70 and71. In the illustrated embodiment, one of thesesides70 is serrated so as to define a plurality of teeth thereon, and theother side71 is non-toothed. In the illustrated embodiment,side71 ofwindow67, as same extends longitudinally, has a generally straight or linear central region and curved end regions on opposite axial sides of the central region. However, it will be appreciated thatside71 may have a linear or straight configuration along its entire longitudinal extent.

Turning now to cuttingelement33, same includes ahub80 which defines the proximal end thereof.Hub80 incorporates a motor-engagingdrive element81 defining a proximally opening bore82 therein in which acoil spring83 is located, and aslot84 which extends transversely to the longitudinal axis of the cuttingelement33.Hub80 additionally includes aneck85 which projects distally fromdrive element81.Neck85 terminates at ahead86 which has an enlarged outer diameter as compared to the remainder ofneck85. In this regard, the outer diameter ofhead86 is slightly larger than the inward projection of therespective stop tabs58 ofseal45. A bore87 extends throughneck85 andhead86, in which an elongate andtubular drive shaft88 is fixed. Driveshaft88 defines therein asuction passage89 which is in communication with asuction port90 defined inneck85, which suctionport90 is in turn in communication withsuction passage20 ofhandpiece11.

Driveshaft88 has adistal end91 which is cut so as to define a window oropening93.Window93 in the illustrated embodiment opens generally sidewardly of thedrive shaft88, such thatdistal end91 is generally closed in the axial direction. The cutting ofdrive shaft88 results in a ring-shaped edge which defines cuttingwindow93. This ring-shaped edge ofdrive shaft88 has circumferentially-spaced and opposed and generally longitudinally-extendingsides94 and95. As best shown inFIGS. 5 and 6,side94 of cuttingwindow93 in the illustrated embodiment is serrated or toothed, and theopposite side95 ofwindow93 is non-toothed and generally straight.

The cuttingelement33 is assembled to the outertubular housing element32 by inserting thedistal end91 ofdrive shaft88 of cuttingelement33 intobore41 at the proximal end ofhub34. During this insertion, theenlarged head86 ofhub80 expands theseal45 andhead86 pushes past thestop tabs58, at which point theseal45 essentially resumes its original shape. Thestop tabs58, while allowing some axial displacement of cuttingelement33 relative tohousing element32, prevent the cuttingelement33 from detaching or falling out of thehousing element32 due to gravitational forces.

The assembledaccessory12 is secured to thehandpiece11 in a similar manner to that described in the '602 publication referenced above, and will accordingly be only briefly described here.Accessory12 is attached to handpiece11 by inserting thehubs34 and80 into the open distal end ofcollet26. Theears37 ofhub34 seat withincollet26, and the lockingring27 serves to hold theaccessory12 withinhandpiece11. The above securement of the accessory12 to handpiece11 causes thedrive element81 to engage themotor output shaft16. More specifically, thedrive pin17 ofoutput shaft16 seats withinslot84 ofdrive element81, such that the rotational movement ofoutput shaft16 is transferred to the cuttingelement33. Thespring83 ofdrive element81 biases the cuttingelement33 forwardly or in the distal direction, so as to maintain thedistal end91 of cuttingelement33 in bearing contact with the interior of the closeddistal end66outer housing element32.

In operation, the distal end oftool10 is inserted into the surgical site. If desirable or necessary, the distal end oftool10 can be inserted into the surgical site through a working portal defined by a conventional cannula or trocar (not shown). The cuttingelement33 is controlled by a control unit (not shown) connected tohandpiece cable18, which control unit supplies electrical power to themotor15 ofhandpiece11 in order to actuate cuttingelement33. Control unit also controls the mode of operation of cuttingelement33, for example by controllingmotor15 so as to drive cuttingelement33 in a forward or reverse direction, or in an oscillating manner. If cutting of tissue is desired, then motor15 is activated so as to cause cuttingelement33 to rotate within and relative toouter housing element32. In this regard, it will be appreciated that the control unit may include appropriate control buttons so as to allow the surgeon or operator to select the desired accessory operations. These control functions of the cuttingelement33 may alternatively be performed directly from thehandpiece11 which would then include the appropriate control buttons thereon. Alternatively, the control unit may be associated with a switch, either through a suitable cable or wirelessly, to allow the surgeon to operate the controls remotely. Such a switch may be a footswitch or a hand switch.

As shown inFIG. 6, with the cuttingelement33 disposed withinhousing element32 and the accessory12 secured to handpiece11 as described above, thetoothed sides94 and70 of the respectivecutting element window93 and thehousing tube window67 are positioned on opposite longitudinal sides of the distal end ofaccessory12, and thenon-toothed sides95 and71 are positioned on opposite longitudinal sides of the distal end ofaccessory12. This configuration allows the accessory12 to perform one type of cutting or cutting style in the forward mode, and in the reverse mode theaccessory12 will perform a different type of cutting or cutting style. Further, in the oscillation mode, wherein the cuttingelement33 oscillates rotationally relative to theouter housing element32 about the longitudinal axis of theaccessory12, theaccessory12 will perform in both cutting styles. More specifically, whenmotor15 is activated in a forward mode to cause cuttingelement33 to rotate within and relative to outer housing element32 (see arrow F inFIG. 6), thetoothed side94 of cuttingelement33 is rotated towards and then past thetoothed side70 ofouter housing element32, which effectively cuts tissue located adjacent or within cuttingwindow67. This “tooth-on-tooth” mode can be utilized when a more aggressive tissue resection is desirable or necessary. Whenmotor15 is activated in a reverse mode (see arrow R inFIG. 6), thenon-toothed side95 of cuttingelement33 is rotated towards and then past thenon-toothed side71 ofouter housing element32 to cut tissue located within/adjacent window67. This “straight-on-straight” mode can be utilized when fine or detailed cutting is desirable or necessary.

If desirable or necessary, suction can be provided at the surgical site by manipulatingvalve22 onhandpiece11 to draw surgical debris from the surgical site throughwindows67 and93, into driveshaft suction passage89, intohandpiece suction passage20 and proximally through thehandpiece11 towards the suction pump.

The accessory12 according to the invention thus allows the combination of two different blade styles into one tool or accessory, which is advantageous in that the surgeon need not remove the accessory12 from the surgical site in order to change to a different cutting style, and can also reduce the costs associated with purchasing multiple blades. It will be appreciated that the accessory12 can be customized for a particular surgical procedure, by providing two different blade styles which are particularly suited to a given surgical procedure. Thus, the “tooth-on-tooth” and “straight-on-straight” cutting styles of theouter housing element32 and cuttingelement33 are provided only as an example of one type of configuration ofaccessory12, and other blade styles can be provided according to the invention.

Further, it will be appreciated that only one of the cuttingwindows67 or93 of thehousing element32 and the cuttingelement33 may be provided with a window having differently-configured cutting edges, and the other element may be provided with a window having cutting edges of the same configuration. This arrangement will still allow two different cutting styles to be carried out upon rotation of the cuttingelement33 in different directions relative tohousing element32. For example, the cutting window of cuttingelement33 can be provided with both toothed and straight cutting edges and the window of thehousing element32 can be provided with two straight cutting edges. This arrangement will provide a “tooth-on-straight” cutting action in one direction of rotation ofelement32, and a “straight-on-straight” cutting action in the opposite direction of rotation.

FIGS. 7-11 illustrate a further embodiment of the invention which will now be described. Components of this embodiment which are similar to or identical to components of the prior embodiment will include the same reference numbers as in the prior embodiment plus “100”, and a detailed description of all components will accordingly not be provided. Thesurgical accessory100 shown inFIGS. 7-11 generally includes anoutermost sheath101, atubular housing element132 and atubular cutting element133. Tubular cuttingelement133 is disposed withinhousing element132, and housing and cuttingelements132 and133 are disposed withinsheath101, such thathousing element132 is located radially betweensheath101 and cuttingelement133 and thus is an intermediate component.

Housing element132 is fixed at its proximal end to ahub134 which is substantially identical tohub34 of the prior embodiment, and thushub134 will not be discussed in detail here except where same differs fromhub34.Housing element132 includes ahousing tube164 defining an elongate bore or conduit165 therein in whichcutting element133 is disposed.Housing tube164 has adistal end166 which is cut on opposite sides so as to define a pair ofwindows173 and174 which open into conduit165.Windows173 and174, in the illustrated embodiment, are disposed approximately 180 degrees from one another along the outer circumference ofhousing tube164.Windows173 and174 each open generally sidewardly of thehousing tube164, such thatdistal end166 thereof is generally closed in the axial direction. Each of the cuttingwindows173 and174 is generally ring-shaped. Cuttingwindow173 has a pair of circumferentially-spaced, opposed and generally longitudinally-extending sides, both of which sides in the illustrated embodiment are serrated or toothed. Theopposite cutting window174 has a pair of circumferentially-spaced, opposed and generally longitudinally-extending sides, each of which sides in the illustrated embodiment is non-toothed or generally straight.

Cuttingelement133 is fixed at its proximal end to ahub180 which is identical tohub80 ofaccessory12 described above. Cuttingelement133 includes atubular drive shaft188, the proximal end of which is mounted within the bore ofhub180. Driveshaft188 defines therein a suction passage189 in communication withsuction port190 ofhub180 andsuction passage20 ofhandpiece11. Cuttingelement133 has adistal end191 which defines a window or opening193 therein.Window193 opens generally sidewardly ofdrive shaft188 such thatdistal end191 is closed in the axial direction. Cuttingwindow193 is generally ring-shaped and has a pair of opposed and generally longitudinally-extending sides, both of which sides in the illustrated embodiment are serrated or toothed.

Turning now tooutermost sheath101, same is defined by atubular wall200 having adistal end201.Distal end201 is cut so as to define awindow202 therein which opens generally sidewardly ofwall200 such thatdistal end201 is closed in the axial direction. Further,tubular wall200 ofsheath101 defines anelongate conduit204 therein in which housing and cuttingelements132 and133 are disposed, and thus the inner diameter ofconduit204 is of a dimension slightly larger than an outer diameter ofhousing tube164 ofhousing element132.

As shown inFIG. 7,sheath101 has aproximal end206 on which anadjustment knob208 is fixed. In one embodiment,knob208 is annular in shape and opens proximally so as to fit overnose139 ofhub134 ofhousing element132, and opens distally so as to mount therein theproximal end206 ofsheath101. In this regard,knob208 is fixed tosheath101, but is rotatably movable relative tohub134 between a first position in whichsheath window202 is circumferentially and axially aligned withwindow173 ofhousing element132, and a second position in whichsheath window202 is circumferentially and axially aligned with theopposite window174 ofhousing element132. These positions, located approximately 180 degrees from one another, may be achieved by providing stops in appropriate positions onnose139 ofhub134.Knob208 may be provided with one or more adjustment levers209 which project outwardly fromknob208 and aid the user in moving theknob208 into the desired rotational position.

The cuttingelement133 is assembled tohousing element132 in the same manner as discussed above relative toaccessory12, and thus such assembly will not be repeated here. Thedistal end166 ofhousing element132 is inserted into the proximal end ofadjustment knob208 and intosheath101, andsheath101 is moved rearwardly relative tohousing element132 untilknob208 seats over and ontonose139 ofhub134.Sheath101 is retained onhub134 in the axial direction via friction or other suitable retaining structures. The assembledaccessory100 is secured to thehandpiece11 in the same manner thataccessory12 is secured tohandpiece11.

In operation, thesheath101 is adjusted to the correct rotational position relative toouter housing element132 usingknob208 so as to exposeappropriate window173 or174 ofhousing element132 depending upon what type of cutting action is desirable or necessary. The distal end ofaccessory12 is inserted into the surgical site, and thehandpiece motor15 activated so as to drive cuttingelement133 in a forward, reverse or oscillating mode.FIG. 9 illustrates the distal end of theaccessory100 when thesheath101 is positioned so that thetoothed cutting window173 ofhousing element132 is exposed, which when the cuttingelement133 is rotated bymotor15 in the forward, reverse or oscillating mode will provide a “tooth-on-tooth” cutting action, for example, to achieve an aggressive cutting action. With thesheath101 in this position, one toothed side of the cuttingwindow193 of cuttingelement133 will rotate towards and past the opposed toothed side of cuttingwindow173 ofhousing element132, which cuts tissue located adjacent/within cuttingwindow173.FIG. 10 illustrates the distal end of theaccessory100 when thesheath101 is positioned so that thenon-toothed cutting window174 is exposed, which when the cuttingelement133 is rotated in the forward, reverse or oscillating mode will provide a “tooth-on-straight” cutting action, for example to make a less aggressive cut than a “tooth-on-tooth” cutting action.

Theaccessory100, as in the first embodiment, thus allows the combination of two different blade styles into one tool or accessory, which avoids the surgeon having to remove the accessory100 from the surgical site and from thehandpiece11 to switch cutting styles.Accessory100 can also help to reduce costs in that not as many blades need be purchased. It will be appreciated that theaccessory100 can be customized for particular surgical procedures, and that the blade configurations provided at the cutting windows may vary from what is depicted herein.

FIG. 11 illustrates an alternative embodiment of the cuttingelement133 described above, which cuttingelement333 can be provided in place of cuttingelement133. Specifically, cuttingelement333 in this embodiment includes atubular drive shaft388 having adistal end391.Distal end391 defines a window or opening393 therein which opens generally sidewardly ofdrive shaft388 such thatdistal end391 is closed in the axial direction. Cuttingwindow393 is generally ring-shaped and has a pair of opposed and generally longitudinally-extending sides, one of which sides394 is serrated or toothed, and the other of which sides395 is generally straight.

In this embodiment, whensheath101 is positioned so as to exposetoothed cutting window173 ofhousing element132, cuttingelement333 when rotated bymotor15 in the forward direction (shown by arrow “F” inFIG. 11) will provide an aggressive “tooth-on-tooth” cutting action via the cooperation oftoothed cutting edge394 of cuttingelement333 andtoothed window173 ofhousing element132, and when rotated bymotor15 in the reverse direction (shown by arrow “R” inFIG. 11) will provide a less aggressive “straight-on-tooth” cutting action via the cooperation ofstraight cutting edge395 andtoothed window173. Whensheath101 is positioned so as to exposestraight cutting window174 ofhousing element132, cuttingelement333 when rotated in the forward direction F will provide a “straight-on-tooth” cutting action via cooperation oftoothed cutting edge394 andwindow174, and when rotated in the reverse direction R will provide a “straight-on-straight” cutting action via cooperation ofstraight cutting edge395 andwindow174 and from the handpiece for a more precise cut.

Thus, the above embodiment which utilizes a cuttingwindow393 which incorporates two different cutting styles in a single cutting window, provides the surgeon with two different cutting styles in each rotational position of thesheath101. This embodiment also avoids the surgeon having to remove the accessory from the surgical site and then from thehandpiece11 in order to change to a different cutting style, and can also reduce the number of accessories which must be purchased and which must be present during a surgical procedure.

It will be appreciated that thehousing element132 may be configured with a cutting window or windows similar to that shown above relative to cutting element333 (in addition to or in place of cutting element333) which may provide additional or alternative cutting styles than those discussed above.

Although particular preferred embodiments of the invention are disclosed in detail for illustrative purposes, it will be recognized that variations or modifications of the disclosed apparatus, including the rearrangement of parts, lie within the scope of the present invention.

Claims (17)

What is claimed is:

1. A surgical cutting accessory configured for being attached to and driven by a powered surgical handpiece, said accessory comprising:

a cutting element assembly including a hub defining a proximal end of said cutting element assembly and configured for cooperation with a drive member of a powered surgical handpiece, and an elongate drive shaft having a proximal end connected to said hub and a distal end defining a first cutting window therein, said first cutting window having a pair of spaced-apart first and second cutting edges; and

an outer housing assembly including a hub defining a proximal end of said outer housing assembly and configured for cooperation with a coupling arrangement provided on a powered surgical handpiece, an elongate and generally tubular housing element in which said drive shaft is disposed for movement relative to said housing element, said housing element having a proximal end connected to said housing assembly hub and a distal end defining a second cutting window therein disposed adjacent said first cutting window of said drive shaft, said second cutting window having a pair of spaced-apart first and second cutting edges, wherein one of said first cutting edge and said second cutting edge of one of said first and second cutting windows has a cutting profile different from the other said cutting edge of said one cutting window;

wherein said cutting profile of said one cutting edge of said one cutting window is toothed and said cutting profile of said other cutting edge of said one cutting window is generally straight.

2. The cutting accessory ofclaim 1, wherein said accessory defines a generally centrally oriented longitudinal axis, said first and second cutting edges of said first cutting window extend generally longitudinally along said distal end of said drive shaft and are spaced circumferentially from one another, and said first and second cutting edges of said second cutting window extend generally longitudinally along said distal end of said housing element and are spaced circumferentially from one another.

3. The cutting accessory ofclaim 2, wherein said drive shaft of said cutting element is rotatably movable relative to and within said housing element in a first direction of rotation to move said first cutting edge of said first cutting window towards said second cutting edge of said second cutting window to achieve a first cutting action, and in a second direction of rotation opposite to said first direction of rotation to move said second cutting edge of said first cutting window towards said first cutting edge of said second cutting window to achieve a second cutting action different from said first cutting action.

4. The cutting accessory ofclaim 1, wherein one of said cutting edges of the other cutting window has a toothed cutting profile and the other of said cutting edges of said other cutting window has a generally straight cutting profile, said drive shaft of said cutting element is rotatably movable relative to and within said housing element in a first direction of rotation to move said one cutting edge of said one cutting window having said toothed cutting profile towards said one cutting edge of said other cutting window having said toothed cutting profile to achieve a first cutting action, and in a second direction of rotation opposite to said first direction of rotation to move said other cutting edge of said one cutting window having said generally straight cutting profile towards said other cutting edge of said other cutting window having said generally straight cutting profile to achieve a second cutting action different from said first cutting action.

5. The cutting accessory ofclaim 1, wherein said one cutting window is disposed on said drive shaft.

6. The cutting accessory ofclaim 1, wherein said first cutting edge of said first cutting window has a first cutting profile and said second cutting edge of said first cutting window has a second cutting profile different from said first cutting profile, said first cutting edge of said second cutting window having a first cutting profile which matches said second cutting profile of said second cutting edge of said first cutting window and said second cutting edge of said second cutting window having a second cutting profile which matches said first cutting profile of said first cutting edge of said first cutting window.

7. The cutting accessory ofclaim 6, wherein said drive shaft of said cutting element is rotatably movable relative to and within said housing element in a first direction of rotation to move said first cutting edge of said first cutting window towards said second cutting edge of said second cutting window to achieve a first cutting action, and in a second direction of rotation opposite to said first direction of rotation to move said second cutting edge of said first cutting window towards said first cutting edge of said second cutting window to achieve a second cutting action different from said first cutting action.

8. The accessory ofclaim 7, wherein said first cutting edge of said first cutting window and said second cutting edge of said second cutting window are toothed, and said second cutting edge of said first cutting window and said first cutting edge of said second cutting window are generally straight.

9. A surgical cutting accessory configured for attachment to a surgical handpiece, said accessory comprising:

a cutting element having a proximal end and a distal end defining a first and second spaced-apart cutting edges thereon; and

an outer housing element in which said cutting element is disposed for movement relative to said housing element, said housing element having a proximal end and a distal end defining first and second spaced-apart cutting edges thereon disposed adjacent said cutting edges of said cutting element, wherein one of said first cutting edge and said second cutting edge of one of said elements has a cutting profile different from a cutting profile of the other said cutting edge of said one element;

wherein said cutting profile of said one cutting edge of said one element is toothed, and said cutting profile of said other cutting edge of said one element is generally straight.

10. The accessory ofclaim 9, wherein each of said cutting element and said housing element is tubular and defines at said distal end thereof a window which opens into an interior of said element, said window having opposite sides respectively defining the respective said first and second cutting edges thereon.

11. The accessory ofclaim 10, wherein said accessory defines a generally centrally oriented longitudinal axis, said window of each said element opens sidewardly in a direction transverse to the accessory axis, and said first and second cutting edges of each said window are spaced circumferentially from one another.

12. The accessory ofclaim 10, wherein said accessory defines a generally centrally oriented longitudinal axis, said window of said cutting element is a first window and said window of said housing element is a second window, said cutting element mounts a hub on said proximal end thereof configured for being rotatably driven by a drive member of a powered surgical handpiece and said housing element mounts a hub on said proximal end thereof configured for attachment to a powered surgical handpiece, said cutting element being rotatably movable relative to and within said housing element in a first direction of rotation to move said first cutting edge of said first cutting window towards said second cutting edge of said second cutting window to achieve a first cutting action, and in a second direction of rotation opposite to said first direction of rotation to move said second cutting edge of said first cutting window towards said first cutting edge of said second cutting window to achieve a second cutting action different from said first cutting action.

13. The accessory ofclaim 12, wherein said first cutting edge of said first cutting window has a first cutting profile and said second cutting edge of said first cutting window has a second cutting profile different from said first cutting profile, said first cutting edge of said second cutting window having a first cutting profile which matches said second cutting profile of said second cutting edge of said first cutting window and said second cutting edge of said second cutting window having a second cutting profile which matches said first cutting profile of said first cutting edge of said first cutting window.

14. A surgical tool assembly comprising:

a powered handpiece including a housing and a motor disposed therein, said motor having an output shaft and said housing mounting a coupling arrangement adjacent a distal end thereof; and

an accessory comprising:

a cutting element assembly having a hub at a proximal end thereof which engages with said output shaft of said handpiece, and an elongate drive shaft having a proximal end connected to said hub and a distal end defining a first cutting window therein, said first cutting window having a pair of spaced-apart first and second cutting edges; and

an outer housing assembly having a hub at a proximal end thereof which engages with said coupling arrangement of said handpiece, an elongate and generally tubular housing element in which said drive shaft is disposed for movement relative to said housing element, said housing element having a proximal end connected to said housing assembly hub and a distal end defining a second cutting window therein disposed adjacent said first cutting window of said drive shaft, said second cutting window having a pair of spaced-apart first and second cutting edges, wherein one of said first cutting edge and said second cutting edge of one of said first and second cutting windows has a cutting profile different from the other said cutting edge of said one cutting window;

wherein said cutting profile of said one cutting edge of said one cutting window is toothed and said cutting profile of said other cutting edge of said one cutting window is generally straight.

15. The surgical tool assembly ofclaim 14, wherein said first cutting edge of said first cutting window has a first cutting profile and said second cutting edge of said first cutting window has a second cutting profile different from said first cutting profile, said first cutting edge of said second cutting window having a first cutting profile which matches said second cutting profile of said second cutting edge of said first cutting window and said second cutting edge of said second cutting window having a second cutting profile which matches said first cutting profile of said first cutting edge of said first cutting window.

16. The surgical tool assembly ofclaim 15, wherein said drive shaft of said cutting element is rotatably movable relative to and within said housing element in a first direction of rotation to move said first cutting edge of said first cutting window towards said second cutting edge of said second cutting window to achieve a first cutting action, and in a second direction of rotation opposite to said first direction of rotation to move said second cutting edge of said first cutting window towards said first cutting edge of said second cutting window to achieve a second cutting action different from said first cutting action.

17. The surgical tool assembly ofclaim 14, wherein said drive shaft of said cutting element is rotatably movable relative to and within said housing element in a first direction of rotation to move said first cutting edge of said first cutting window towards said second cutting edge of said second cutting window to achieve a first cutting action, and in a second direction of rotation opposite to said first direction of rotation to move said second cutting edge of said first cutting window towards said first cutting edge of said second cutting window to achieve a second cutting action different from said first cutting action.

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